Phi Life Sciences LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHI LIFE SCIENCES LLC

Practice address

4701 Melbourne PL Ste A2
College Park, MD 20740-2540

Phone

(888) 576-5445

Fax

(888) 738-2470

NPI assigned

Dec 21, 2018

Last updated

Mar 25, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sawan Hurst, MS

Title

Ceo

Phone

(888) 576-5445

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Phi Life Sciences LLC

  • Clinical Medical Laboratory
  • Charleston, SC
  • NPI 1437605615

  0345520532

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Phi Life Sciences LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phi Life Sciences LLC

  • Clinical Medical Laboratory
  • Charleston, SC
  • NPI 1437605615
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1386116846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 MEETING ST STE 3",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294034277",
            "telephone_number": "888-576-5445",
            "fax_number": "843-724-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 MELBOURNE PL STE A2",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207402540",
            "telephone_number": "888-576-5445",
            "fax_number": "888-738-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHI LIFE SCIENCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "SAWAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-576-5445",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "21D2158103",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia N Perry, ATC
• David Petersen, PH.D.
• Kimberly Lynn Pfister, PA-C
• Melissa Pforr, ATC
• PHC Healthcare LLC
• Pepper Ellen Phillips
• Theodore Pickett Jr., PH.D.
• Shaunice Latrice Powell
• Astin Shea Powers, MD
• Pregnancy Aid Centers, Inc. (Pregnancy Aid Center)

• Clinical Medical Laboratory in College Park, MD
• Providers in College Park, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.